右心室 - 肺动脉合在化症相关的肺动脉高血压
Jose Leonidas Alves-Jr1, Eduardo Leite Vieira Costa2, Susana Hoette2
1Pulmonary Division - Instituto do Coração (InCor) - Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo, SP, Brazil; Interventional Cardiology Division - Instituto do Coração - Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo (InCor - HCFMUSP), São Paulo, SP, Brazil.
由于改善了右心室 - 动脉肺 (RV-PA) 合,发生了较好的肺动脉高血压 (Sch-PAH). 这种RV-PA合是Sch-PAH患者的一个关键的独立预后标志物.
科学领域:
- 心脏病学 心脏病学
- 肺部病理学 肺部病理学
- 血管生物学 血管生物学
背景情况:
- 石斯托索米亚症相关的肺动脉高血压 (Sch-PAH) 呈现出比异常性肺动脉高血压 (IPAH) 更好的预后.
- 尚不清楚Sch-PAH更好的临床过程背后的机制.
- 右心室 - 动脉肺 (RV-PA) 合是心脏对肺血管疾病反应的潜在标志物,但未在Sch-PAH中进行研究.
研究的目的:
- 为了评估与IPAH相比,Sch-PAH患者的RV-PA合.
- 为了确定RV-PA合是否与Sch-PAH的生存有关.
主要方法:
- 在2013年至2018年间进行右心导管治疗 (RHC) 的Sch-PAH或IPAH患者的回顾性队列研究.
- 从RHC压力曲线计算出右心室在静脉末端 (Ees) 的弹性和肺动脉弹性 (Ea).
- 评估RV-PA合是以Ees与Ea的比率进行评估.
主要成果:
- 与IPAH患者 (n=68) 相比,Sch-PAH患者 (n=33) 呈现出较高的RV-PA合 (0.95±0.58与0.67±0.41;p=0.004) 和Ees (2.07±1.65与1.33±0.91;p=0.005) 的情况.
- 尽管年龄较大,但Sch-PAH患者的生存率更高 (p=0.031).
- 在多变量分析中,RV-PA合是生存的独立预后标志物 (p=0.030;HR=0.287).
结论:
- 在Sch-PAH中,RV-PA合更好地保存.
- 增强的RV-PA合显著与Sch-PAH的生存率改善有关.
- 保存的RV-PA合可能解释了Sch-PAH的更好的临床过程.
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